NR572 Exam 1 Actual Exam Style V2 | NR
572 Advanced Acute Care Management |
Chamberlain
1. When treating a patient in septic shock, which of the following is the priority intervention
within the first hour of recognition?
A. Perform a CT scan of the abdomen and pelvis.
B. Administer a 500 mL bolus of 5% Albumin.
C. Start a low-dose vasopressin infusion.
D. Obtain blood cultures and initiate broad-spectrum antibiotics.
Correct Answer: D
Expert Explanation: Obtaining blood cultures and starting broad-spectrum antibiotics is a
core component of the 1-hour sepsis bundle. Early antimicrobial therapy significantly
reduces mortality rates in patients with severe infection. Delays in treatment are
associated with a progressive increase in the risk of death.
2. A patient’s hemodynamic monitor shows a Mean Arterial Pressure (MAP) of 58 mmHg.
Which physiological consequence is most concerning?
A. Increased venous return to the right atrium.
B. Inadequate perfusion to vital organs such as the kidneys and brain.
C. Transient increase in cardiac output via the Frank-Starling mechanism.
,D. Decreased systemic vascular resistance due to vasodilation.
Correct Answer: B
Expert Explanation: A MAP of at least 65 mmHg is generally required to maintain
adequate tissue perfusion. When MAP falls below this threshold, vital organs may suffer
from ischemic injury. Sustained hypotension can lead to multi-organ dysfunction syndrome
(MODS).
3. In the management of Acute Respiratory Distress Syndrome (ARDS), what is the primary
goal of utilizing low tidal volume ventilation?
A. To maximize oxygenation by recruitment of collapsed alveoli.
B. To prevent ventilator-induced lung injury (VILI) from volutrauma.
C. To decrease the patient’s work of breathing and respiratory rate.
D. To increase the functional residual capacity (FRC) through PEEP.
Correct Answer: B
Expert Explanation: Low tidal volume ventilation, typically 6 mL/kg of predicted body
weight, helps prevent overdistension of the alveoli. This strategy reduces the risk of
barotrauma and volutrauma in fragile lung tissue. It has been shown to improve survival
outcomes in clinical trials like ARDSNet.
, 4. A patient in the ICU is being monitored with a Pulmonary Artery (PA) catheter. The nurse
notes a Pulmonary Artery Wedge Pressure (PAWP) of 22 mmHg. This finding most likely
indicates:
A. Left-sided heart failure or fluid volume overload.
B. Right ventricular infarction and decreased preload.
C. Hypovolemic shock requiring fluid resuscitation.
D. Pulmonary hypertension resulting from chronic lung disease.
Correct Answer: A
Expert Explanation: PAWP reflects left atrial pressure and left ventricular end-diastolic
pressure. A normal PAWP is typically 6 to 12 mmHg, so a value of 22 mmHg suggests
significant congestion. This is commonly seen in cardiogenic shock or hypervolemia.
5. Which of the following laboratory findings is most characteristic of the early stages of
Disseminated Intravascular Coagulation (DIC)?
A. Increased fibrinogen levels and decreased PT/PTT.
B. Decreased BUN and creatinine levels with polycythemia.
C. Normal platelet count with isolated Vitamin K deficiency.
D. Thrombocytopenia, elevated D-dimer, and prolonged PT.
Correct Answer: D
572 Advanced Acute Care Management |
Chamberlain
1. When treating a patient in septic shock, which of the following is the priority intervention
within the first hour of recognition?
A. Perform a CT scan of the abdomen and pelvis.
B. Administer a 500 mL bolus of 5% Albumin.
C. Start a low-dose vasopressin infusion.
D. Obtain blood cultures and initiate broad-spectrum antibiotics.
Correct Answer: D
Expert Explanation: Obtaining blood cultures and starting broad-spectrum antibiotics is a
core component of the 1-hour sepsis bundle. Early antimicrobial therapy significantly
reduces mortality rates in patients with severe infection. Delays in treatment are
associated with a progressive increase in the risk of death.
2. A patient’s hemodynamic monitor shows a Mean Arterial Pressure (MAP) of 58 mmHg.
Which physiological consequence is most concerning?
A. Increased venous return to the right atrium.
B. Inadequate perfusion to vital organs such as the kidneys and brain.
C. Transient increase in cardiac output via the Frank-Starling mechanism.
,D. Decreased systemic vascular resistance due to vasodilation.
Correct Answer: B
Expert Explanation: A MAP of at least 65 mmHg is generally required to maintain
adequate tissue perfusion. When MAP falls below this threshold, vital organs may suffer
from ischemic injury. Sustained hypotension can lead to multi-organ dysfunction syndrome
(MODS).
3. In the management of Acute Respiratory Distress Syndrome (ARDS), what is the primary
goal of utilizing low tidal volume ventilation?
A. To maximize oxygenation by recruitment of collapsed alveoli.
B. To prevent ventilator-induced lung injury (VILI) from volutrauma.
C. To decrease the patient’s work of breathing and respiratory rate.
D. To increase the functional residual capacity (FRC) through PEEP.
Correct Answer: B
Expert Explanation: Low tidal volume ventilation, typically 6 mL/kg of predicted body
weight, helps prevent overdistension of the alveoli. This strategy reduces the risk of
barotrauma and volutrauma in fragile lung tissue. It has been shown to improve survival
outcomes in clinical trials like ARDSNet.
, 4. A patient in the ICU is being monitored with a Pulmonary Artery (PA) catheter. The nurse
notes a Pulmonary Artery Wedge Pressure (PAWP) of 22 mmHg. This finding most likely
indicates:
A. Left-sided heart failure or fluid volume overload.
B. Right ventricular infarction and decreased preload.
C. Hypovolemic shock requiring fluid resuscitation.
D. Pulmonary hypertension resulting from chronic lung disease.
Correct Answer: A
Expert Explanation: PAWP reflects left atrial pressure and left ventricular end-diastolic
pressure. A normal PAWP is typically 6 to 12 mmHg, so a value of 22 mmHg suggests
significant congestion. This is commonly seen in cardiogenic shock or hypervolemia.
5. Which of the following laboratory findings is most characteristic of the early stages of
Disseminated Intravascular Coagulation (DIC)?
A. Increased fibrinogen levels and decreased PT/PTT.
B. Decreased BUN and creatinine levels with polycythemia.
C. Normal platelet count with isolated Vitamin K deficiency.
D. Thrombocytopenia, elevated D-dimer, and prolonged PT.
Correct Answer: D
